Free Acknowledgment of Receipt - District Court of Delaware - Delaware

Case 1:05-cv-00375-Gl\/IS Document 2 Filed 06/17/2005 Page 1 of 1
AO FORM S5 RECEIPT SREV. 9/O4)
United States District Court for the District of Delaware
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ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OFA VAILABILITY OFA
UNITED STA TES MAGISTRA TE JUDGE
T O EXERCISE J URISDI CT I ON
1 HEREBY ACKNOWLEDGE RECEIPT or 5 COPIES OF AO FORM 85.
A I .- -E
(Date forms issued) Si nature of ‘" °‘6`Y* l€’li'e:i°1· Representative)
_ (Printed nameh f Party or their Representative)
Note: Completed receigt will be filed in the Civil Action